Compression and support dressings are widely known for use in a variety of medical purposes. A particular area where compression dressings are considered important is in the care and treatment of venous stasis leg ulcers.
For example, venous stasis leg ulcers are believed to be the result of venous insufficiency, i.e., incompetent vein perforator valves, in the leg. One main focus of treatments for leg ulcers is the dermatological care. Indeed, many workers in this area feel that care to the surrounding skin of the leg and protection of the epithelium (delicate healing area directly peripheral to the ulcer) are crucial to successful treatment of leg ulcers. Care to the surrounding skin includes treatment of psoriatic conditions which often accompany leg ulcers, avoidance of skin sensitization from agents in the dressing, prevention of skin maceration and preventing damage from the ulcer exudate.
The mainstay, however, of nearly all venous stasis leg ulcer treatments is the application of compression. Elasticated bandages, and the like, have been extremely suitable for this purpose. Properly applied compression is thought to enhance circulation and thereby alleviate at least some of the cause of the venous stasis ulcers. These compression bandages also serve to keep the desired gauze or primary dressing flatly and firmly in place over the ulcer.
Typical extensible bandages suitable for compression include adhesive rubber bandages (e.g., Elastic PEG from Becton Dickinson; Elastoplast from Beiersdorf, Inc., Elasti Kon from Johnson & Johnson; Conform Elastic Tape from Kendall; Flexoplast from Edward Taylor Ltd.; Coban from 3M), plain cotton bandages (e.g., Tomac from American Hospital Supply; Dixie from Chaston Medical), cotton bandages reinforced with Lycra/Spandex (e.g., Ace Bandage from Becton Dickinson; Elastic Bandage from Conco Medical; Turniwrap from Richards Mfg.; Elastic Bandage from Edward Weck & Sons), cotton reinforced with rubber (e.g., Dynaflex from Johnson & Johnson; Ace Centur from Becton Dickinson, and the like), tubular open netted elastic (e.g., Spandage Stretch from Medi Tech Int'l), cotton conforming bandages, cotton crepe bandages, elastic adhesive bandages (which may include zinc oxide), and the like.
Some extensible bandages known in the art also include ravel-resistant side edges and may include an adhesive on one or both major surfaces so as to be self-adhesive or adhesive to the skin of the wearer. One major importance of using an adhesive has been that it can reduce the slippage of the wrapped compression bandage while the patient moves, thereby providing more uniform support and compression for extended periods of time.
U.S. Pat. No. 4,699,133 to Schafer et al. describes a self-adhesive support bandage which is air and moisture permeable. Small adhesive particles are applied only to the raised fiber edges of the bandage so that adhesion to skin and hair is avoided.
Also useful in the treatment of venous leg ulcers are the impregnated paste type bandages. These are typically in the form of a tape (Viscopaste PB7) or conformal boot (Unna's Boot) which are impregnated with zinc paste and the primary purpose of these dressings is to soothe the surrounding skin.
Additional support can be provided by securing-type dressings, such as Tubigrip, which are employed to keep the other articles in place when combinations of products are employed. In fact, the most widely accepted methods for treating venous leg ulcers utilize several of the above-described products in combination. For example, the gauze or primary wound dressing can be placed over the ulcer and is then wrapped or covered with a paste type dressing. This is followed with a compression bandage and optionally with a securing-type bandage.
Although this combination has been relatively effective, it is not without drawbacks. Primarily, it comprises three or four separate elements which becomes expensive, bulky and very time consuming for the caregiver. If the paste bandage is eliminated, the surrounding skin is not adequately cared for, and if the securing bandage is eliminated, slippage of the various components is likely to occur.